Animal Clinic of Walla Walla

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  • Home
    • PDF Forms
  • About Us
  • Services
    • Preventive Care
    • Dentistry
    • Surgery
    • Laboratory
    • Diagnostic Imaging
    • Pharmacy
    • Boarding
    • Emergency
    • End of Life Care
  • Our Team
    • Veterinarians
    • Licensed Veterinary Technician
    • Veterinary Assistants
    • Client Services
  • Contact Us
    • New Clients
  • Vetsource

Hospital Admission Form

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ANIMAL CLINIC OF WALLA WALLA

2089 Taumarson Road
Walla Walla, WA 99362
Phone (509) 525-6111 Fax (509) 525-6102
info@animalclinicww.com

Bret K. Smith, DVM
Alexandra Colton-Ashcraft, DVM
Daniel Prendiville, DVM

MM slash DD slash YYYY
May we sedate your pet if necessary?
May we perform blood work if necessary?
May we take x-rays if necessary?
If your pet is found to have transmissible conditions such as fleas, ticks, ear mites, or fungal infections, the clinic must treat such conditions to prevent spread to other patients. Admission of your pet to the hospital constitutes permission for treatment of such transmissible conditions and acceptance of financial responsibility for such treatment.
If vaccinations are not current, would you like to update them today?
Which of the following have you observed in the past week?
Change in activity? If YES, please explain.
Loss of appetite? If YES, please explain.
Excessive drinking? If YES, please explain.
Abnormal bowel movements ? If YES, please explain.
Vomiting? If YES, please explain.
Straining to urinate? If YES, please explain.
Increased urination? If YES, please explain.
Coughing? If YES, please explain.
Sneezing? If YES, please explain.
I give my consent and accept financial responsibility for the procedure(s) performed today. Even though animals are given a pre-procedure exam, I understand that there are risks involved in the administration of general anesthesia and in performing all surgeries, and therefore I give my permission for treatment of unforeseen conditions which may arise during anesthesia, surgery, and recovery. I understand that payment is due in full upon my pet’s discharge.
My method of payment will be:*
Clear Signature

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